Bronx High School of Science Case• Three teens on the track team arrested with charges of forcible

touching, assault, hazing in the second degree, and harassment• Allegations:• Teammate pinned, sexually assaulted by touching, or hitting genitals • “You need a good fingering, you freshman,” before using a digit to

sodomize the victim though his shorts.• “Touch my penis for three seconds or I will rape you”

• Athletic director and two track coaches were suspended• New ADs and sensitivity training for athletes• School website features a form for students to anonymously

report bullying• Teens attending another school according to DOE

News 12 Bronx, NY Daily News, Wall Street Journal

Pediatricians and Bullying

Legislative Advocacy TalkDaniel Yu and Pam FazzioMarch 2013

Definitions of Bullying• Attack or intimidation with the intention to cause fear,

distress, or harm

• A real or perceived imbalance of power between the bully and the victim

• Repeated attacks or intimidation between the same children over time.

• AAP definition: A form of aggression in which one or more children repeatedly and intentionally intimidate, harass, or physically harm a victim who cannot defend herself or himself.

“Role of the Pediatrician in Youth Violence Prevention.” Pediatrics 2009;124;393.

Types of Bullying

• Physical (hitting, spitting, tripping)• Verbal (name calling, teasing)• Psychological/social (spreading rumors, leaving

out of group)• Cyber-bullying; e-mail, chat room, text

messaging• Sexual (touching, bra snapping)

Bullying Statistics

• Bullying is widespread

• 2011 Nationwide survey, 20% of high school students reported being bullied on school property in the 12 months preceding the survey.

• 16% of high school students reports being bullied electronically in the 12 months before the survey.

Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2011. MMWR, Surveillance Summaries 2012;61(no. SS-4).

Risk Factors• Those perceived to be “different”

• Overweight or underweight, wearing glasses or different clothing, being new to a school

• Youth with disabilities

• LGBT youth

• Socially isolated youth

Effects on HealthBully victims:

• Anxiety, depression, death• Increased sadness and loneliness• Changes in sleep and eating patterns• Health complaints• Decreased academic achievement• Miss, skip, or drop out of school.

• Bullied children might retaliate through extremely violent measures. In 12 of 15 school shooting cases in the 1990s, the shooters had a history of being bullied.

Smokowski PR, Kopasz KH. Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. Children and Schools 2005; 27:101-109.

Effects on Health

Youth who bully others are more likely to:

• Abuse alcohol • Substance use• Get into fights, vandalize property• Drop out of school• Engage in early sexual activity• Have criminal convictions as adults • Be abusive towards spouses or children as adults

Smokowski PR, Kopasz KH. Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. Children and Schools 2005; 27:101-109.

Bullying and Suicide

• Suicide is the 3rd most common cause of death in youth

• Although kids who are bullied are at risk of suicide, many issues contribute to suicide risk, including depression, problems at home, and trauma history.

• Specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth.

• Bullying and suicide. A review. Kim YS, Leventhal B. Child Study Center

Cases of Suicide

Ryan Patrick Halligan

Megan Taylor Meier

Amanda Todd

Tyler Clementi

Celebrity Responses

• Anti-bullying public service announcements from cast members of Glee

• Ellen Degeneres• Lady Gaga• Madonna• Athletes

BULLY Trailer

NY Anti-bullying Legislations

Dignity for All Students Act (DASA)• NYS's Anti-Bullying Law that first created

guidelines for local school districts to develop policies and procedures to address the problem of bullying• Signed into law in 2010, took effect in July 2012 • All public elementary and secondary school

students are protected

Dignity for All Students Act (DASA)• Each school's Code of Conduct must be amended to reflect the

prohibition of harassment and discrimination

• Districts must appoint at least one staff member in each school to handle all bullying incidents on school property (including athletic fields, playgrounds, and parking lots), in school buildings, on a school bus/vehicle, as well as at school-sponsored events or activities).

• Administrators must report incidents of bullying or bias-based harassment to the NYS Department of Education

• The curriculum for every grade, K – 12, must include a course on civility, citizenship and character education.

S7740: bullying and cyberbullying

• School districts are required to institute protocols addressing bullying/ cyberbullying

- Students and parents to make both oral and written reports - Assignment of a school official to receive and investigate reports - Responsive actions to prevent recurrence of any verified bullying - Coordination with law enforcement when appropriate - Development of a bullying prevention strategy - Notice to all school community members of the school’s policies. - A copy of the school policy on such matters annually provided to all employees, students and parents.

NY Anti-bullying LegislationsThe law organizes training requirements for school employees

“Teacher training programs”

Law to Encourage the Acceptance of All Differences (LEAD)

• Addresses bullying more directly.• It gives the term “bullying” a specific definition• Requires the curriculum in all grades, K – 12, to include a

component on discouraging acts of bullying• Rather than simply requiring anti-bullying policies, it spells

out the specific actions that school districts must take to prevent bullying before it happens, and respond to cases where bullying is already occurring.

• LEAD was passed by the Senate in 2011• Needs to be passed by the Assembly and signed by

Governor Cuomo before it can become law.

Tyler Clementi Higher Education Anti-Harassment Act• Federal Legislation

• Currently no federal requirement that colleges and universities have policies to protect their students from harassment

• Requires colleges and universities to enact an anti-harassment policy and distribute this policy to all students and employees

Tyler Clementi Higher Education Anti-Harassment Act

• The bill creates a competitive grant program at the Department of Education

• Institutions can apply for funding to expand bullying and harassment prevention programs

• The bill was reintroduced in the 113th Congress in the House by Rep. Rush Holt (D-NJ) and in the Senate by Sen. Frank Lautenberg (D-NJ) on February 4, 2013.

Anti-bullying Bill of Rights (NJ)• Propelled by public outcry over the suicide of Tyler Clementi• Signed by Governor Christie in 2011• Considered the toughest legislation against bullying in the

nation• Requires all public schools adopt comprehensive antibullying

policies (there are 18 pages of “required components”)• Increase staff training and adhere to tight deadlines for

reporting episodes.

Anti-bullying Bill of Rights (NJ)• Each school must designate an antibullying specialist to investigate

complaints; each district must, in turn, have an antibullying coordinator; and the State Education Department will evaluate every effort, posting grades on its Web site.

• Safety team at each school, made up of teachers, staff members and parents, to review complaints.

• Principals to begin an investigation within one school day of a bullying episode, and superintendents to provide reports to Trenton twice a year detailing all episodes.

• Educators who fail to comply could lose their licenses.

The Bully Police

A watchdog organization that reports on and grades states’ anti-bullying legislation.

• New York B-• New Jersey A++• South Dakota B+ (49th State to pass a Law)• Montana F (Only state with NO anti bullying law)

Role of the PediatricianPrimary prevention:• Explain the difference between normal and abnormal;• Encourage parents to provide plenty of love and attention;• Foster positive self-esteem;• Encourage parents to talk with their children, not at them;• Emphasize the importance of parental supervision;• Aid parents in setting limits;• Teach responsibility;• Help parents teach problem-solving and decision-making skills;• Assist parents with helping their children minimize and manage stress;• Foster anger and conflict management;• Teach tolerance;• Enforce family values;• Minimize the effects of peer pressure;• Instruct parents to monitor their children's media use;• Help parents keep their children away from drugs;• Keep children away from guns and other weapons;• Empower parents to be responsible role models; and• Urge parents to get involved.Mary E. Muscari. How Healthcare Providers Can Prevent Bullying: A Form of Youth Violence. Medscape. Sep 08, 2009.

Role of the PediatricianPrimary prevention:• Explain the difference between normal and abnormal;• Encourage parents to provide plenty of love and attention;• Foster positive self-esteem;• Encourage parents to talk with their children, not at them;• Emphasize the importance of parental supervision;• Aid parents in setting limits;• Teach responsibility;• Help parents teach problem-solving and decision-making skills;• Assist parents with helping their children minimize and manage stress;• Foster anger and conflict management;• Teach tolerance;• Enforce family values;• Minimize the effects of peer pressure;• Instruct parents to monitor their children's media use;• Help parents keep their children away from drugs;• Keep children away from guns and other weapons;• Empower parents to be responsible role models; and• Urge parents to get involved.Mary E. Muscari. How Healthcare Providers Can Prevent Bullying: A Form of Youth Violence. Medscape. Sep 08, 2009.

Role of the Pediatrician

• Secondary prevention:• Screen for bullying during well visits• Screen patients who present with school phobia, mood or

behavioral problems, or psychosomatic complaints• Screen for depression and SI

• Tertiary prevention:• Refer to a mental health professional a child displays

consequences of bullying

Mary E. Muscari. How Healthcare Providers Can Prevent Bullying: A Form of Youth Violence. Medscape. Sep 08, 2009.

Identifying the Bullies• Poorest outcomes are among bullies themselves• Bullies usually receive poor grades and lack good connections

with their teachers, independent of intelligence• Children labeled by their peers as bullies at age 8 are more

likely to end up incarcerated, less likely to be steadily employed, less likely to be in stable long-term romantic relationships by the time they reach age 30

• Little evidence supports the idea that bullies have poor self-esteem

• May be bullied themselvesAAP Connected Kids

• Parents, kids, teachers• Signs of bullying, how to talk about it• Cartoon videos for kids• Laws by state (what they include)• Spanish site

Questions and Comments…be nice, no bullying